Top Things to Know: Ultraprocessed Foods and Their Association With Cardiometabolic Health
Published: August 08, 2025
Prepared by Radhika Rajgopal Singh, SVP, American Heart Association and Sally Wong, National Senior Director, American Heart Association
- Evidence continues to support the growing public health concern of adverse health outcomes tied to high consumption of ultraprocessed foods (UPF). This science advisory summarizes current knowledge and gaps in understanding of UPFs, their association with cardiometabolic health and opportunities for a multipronged strategy involving funding research priorities, modernizing FDA’s evaluation of additives and broader systemic and policy improvements.
- Though several food processing frameworks exist, the adverse associations of Nova-defined UPFs on health are the most documented and are the focus of the current statement. Designed in Brazil, the Nova Food Classification system groups foods according to the nature, extent, and purpose of industrial food processing applied; the categorization does not include a breakdown of the nutritional quality of the foods.
- Not all foods that undergo industrial processing are classified as UPFs. Certain types of industrial food processing are beneficial for preservation and safety and/or lowering cost, such as techniques that extend shelf life, control microbial growth, mitigate chemical toxicants, preserve functional, nutritional, and sensory qualities, and reduce food loss and waste.
- While ultraprocessing may reduce food cost and enhance stability, convenience, and palatability, there is consistent evidence that dietary patterns high in UPFs consumption are associated with adverse health outcomes. Most, but not all, UPFs have imbalanced nutritional profiles that contribute to excess energy, saturated fats, added sugars, and sodium (high fat, sugars, salt or HFSS) intake, which impact health through multiple mechanisms.
- Accumulating evidence also suggests that some, but not all, additives and processing methods may adversely affect health and improved monitoring of both existing and emerging food additives presents a critical opportunity for innovation in food safety, waste reduction, and nutritional enhancements.
- In addition to incomplete mechanistic understanding of how UPFs affect health, the current classification based on the Nova definition requires some interpretation, domain expertise, and consensus, adding to the challenges in implementing public health policies, especially in some countries where >50% of foods are UPFs, and in cases where some UPFs with better nutritional profiles may contribute to food and nutrition security.
- Some UPF subgroups, like certain whole grain breads, low-fat dairy, and plant-based products, may support healthy diets. This highlights the need for precise subcategorization and complete understanding of UPFs, considering geographical context, additives, processing techniques, population traits, and disease conditions, rather than broadly limiting all UPFs.
- Limited access to healthy foods and an overabundance of mostly inexpensive, heavily marketed, HFSS UPFs characterize the imbalances in UPF purchasing and consumption that disproportionately impact low-income and historically under-resourced communities.
- Innovative research, like the application of machine-learning tools to assess the degree of food processing and its impact on health outcomes with a data-driven rather than qualitative framework, can be an important first step to inform policy and systems-level translation.
- The advisory proposes 4 substantive changes to drive positive health outcomes. These include the introduction of multi-level approaches for individuals, food manufacturers, and the retail industry; enactment of multipronged policy and systems-change strategies; increased research funding to fully understand the mechanistic relationships between UPFs and cardiometabolic health; and a need to modernize FDA's food additive science, including streamlined and efficient evaluation and regulation of food additives.
Citation
Vadiveloo MK, Gardner CD, Bleich SN, Khandpur N, Lichtenstein AH, Otten JJ, Rebholz CM, Singleton CR, Vos MB, Wang S; on behalf of the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Genomic and Precision Medicine; and Stroke Council. Ultraprocessed foods and their association with cardiometabolic health: evidence, gaps, and opportunities: a science advisory from the American Heart Association. Circulation. Published online August 8, 2025. doi: 10.1161/CIR.0000000000001365